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Private sector involvement and competition have not improved healthcare in England, report shows

BMJ 2014; 348 doi: (Published 11 April 2014) Cite this as: BMJ 2014;348:g2671
  1. Nigel Hawkes
  1. 1London

There is little evidence that market reforms have had any appreciable effect on the NHS’s performance in England, the Nuffield Trust and the Health Foundation have found in a new comparison of health services in the four countries of the United Kingdom.1

Although performance in England had improved, the study found the same to be true of Scotland and, until recently, Wales—neither of which had undergone the same reforms. Spending more money and setting tough targets seemed to have been the main cause of the improvements rather than patient choice, competition between providers, or private sector involvement.

However, England still performed marginally better across a number of key indicators while spending less; if its spending matched Scotland’s, England would have to find another £10bn (€12.1bn; $16.8bn) a year. England is richer, so the report said that a better comparison would …

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